晚期食管癌不同化疗方案疗效对比

摘要

Objective To analyze efficacy and side effects of Fluorouracil, Taxane, and Platinum combinations in the treatment of advanced esophageal poisoning, and explore the best drug treatment mode. Methods A total of 97 cases of advanced or recurrent esophageal cancer from September 2009 to May 2012 in the First People's Hospital of Yangzhou City were retrospectively analyzed;patients were divided into four groups according to their regimen: 22 cases of Fluo-rouracil combined with Platinum (group A), 21 cases of Fluorouracil combined with Taxane (group B), 15 cases of Tax-ane combined with Platinum (group C) and 39 cases of three drugs (group D). The efficacy and toxicity were assessed. Results Objective response rates of group A, B, C, D were 45.5%, 42.9%, 48.7% and 53.3% respectively, there was no statistically significant difference in four groups (P>0.05). Analysis of long-term effects, four groups had no statistical-ly significant difference in PFS and OS (P > 0.05), although the three drugs scheme improved the mPFS in a certain extent. Stratified analysis for the patients with first-line treatment, there were also no significant differences between groups (P> 0.05). Chemotherapy-related toxicities were mainly myelosuppression, nausea, vomiting and constipation. Compared with group C, Incidences of diarrhea and hand-foot syndrome in group D were significantly increased (P<0.05). Conclusion There are different adverse reactions but no different efficacy of Fluorouracil, Taxane and Platinum combinations for advanced esophageal cancer treatment. Three drugs scheme bring more serious adverse events, pa-tients with good physical conditions can be used with caution.%目的：分析氟尿嘧啶类、紫杉类、铂类药物不同组合方案在晚期食管癌治疗中的效果及毒副作用，探讨晚期食管癌最佳药物治疗方案。方法回顾分析2009年9月~2012年5月扬州市第一人民医院治疗的97例晚期或复发转移食管癌患者的临床资料。按其化疗方案进行分组，将采用氟尿嘧啶联合铂类、氟尿嘧啶类联合紫杉类、紫杉类联合铂类以及三药联合方案治疗的患者分为A(22例)、B(21例)、C(39例)、D(15例)四组，分析各组疗效及毒副作用。结果四组患者客观有效率分别为45.5%、42.9%、48.7%、53.3%，差异无统计学意义(P>0.05)。远期疗效分析，四组进展生存期、总生存期比较，差异均无统计学意义(P>0.05)，尽管三药联合方案在一定程度上提高了中位无进展生存期，但差异无统计学意义(P>0.05)。对一线治疗患者进行分层分析，各组间差异均无统计学意义(P>0.05)。各组化疗相关毒副作用均主要为骨髓抑制、恶心呕吐及便秘，D组腹泻和手足综合征发生例数较C组明显增加(P<0.05)。结论氟尿嘧啶、紫杉类、铂类药物不同组合方案在晚期食管癌治疗中效果并无明显差异，化疗相关不良反应表现不同，三药联合方案毒副作用发生率较高，对体力状况评分较好患者可谨慎使用。